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Hefelfinger L, Doherty A, Wahab R, Rosen L, Shaughnessy EA, Lewis JD. Evaluation of the SmartClip™ Nonradioactive Seed, a Novel Wireless Localization Method for the Breast: Initial Clinical Experience and Surgical Outcome. Am Surg 2024; 90:592-599. [PMID: 37749932 DOI: 10.1177/00031348231199171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
INTRODUCTION Wire localization has been the gold standard for breast localization of non-palpable lesions for decades. This technique remains robust but has disadvantages relative to scheduling, complications of vasovagal reactions in placement, wire migration, or transection. With more modern technologies available, several implantable markers have been developed to allow uncoupling of localization by radiology and the surgical procedure on the same day. This study summarizes our experience with the EnVisio Navigation System™ utilizing SmartClip™ as the implantable tissue localization marker. METHODS An IRB-approved retrospective database of benign and malignant breast disease was used to perform a review of 100 consecutive patients who underwent SmartClip™ localized breast and axillary procedures in 2021. Demographic information, localization accuracy, associated surgical procedure(s) with resultant pathology findings, margin status for malignancies, and re-excision rate were collected. RESULTS The localized breast lesion or lymph node was excised and SmartClip™ retrieved in all cases, confirmed by intraoperative specimen radiograph. The distribution of gender and race/ethnicity among the patients who underwent surgery reflects the community population and frequency of breast cancer development among men versus women. 45.1% of the cases involved malignancy, as determined pre-operatively. Positive margins requiring re-excision constituted 18.2% of cases. In twenty-six patients, two or three SmartClips™ were placed per case for either a bracketed lesion, two separate breast lesions, and/or a breast lesion and lymph node. CONCLUSION Although this study is limited in patient number, it demonstrates safety of this technique and its reliability in guiding the surgeon directly to the lesion(s) of concern.
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Affiliation(s)
- Leah Hefelfinger
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | | | - Rifat Wahab
- Department of Radiology, Division of Breast Imaging, University of Cincinnati, Cincinnati, OH, USA
| | - Lauren Rosen
- Department of Pathology, Section of Surgical Pathology within the Division of Anatomic Pathology, University of Cincinnati, Cincinnati, OH, USA
| | - Elizabeth A Shaughnessy
- Department of Surgery, Division of Surgical Oncology, University of Cincinnati, Cincinnati, OH, USA
| | - Jaime D Lewis
- Department of Surgery, Division of Surgical Oncology, University of Cincinnati, Cincinnati, OH, USA
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Affiliation(s)
- Jiewen Li
- From the Division of Breast Radiology, Department of Diagnostic Radiology, University of Cincinnati Medical Center, 3151 Bellevue Ave, Cincinnati, OH 45219
| | - Rifat Wahab
- From the Division of Breast Radiology, Department of Diagnostic Radiology, University of Cincinnati Medical Center, 3151 Bellevue Ave, Cincinnati, OH 45219
| | - Ann L Brown
- From the Division of Breast Radiology, Department of Diagnostic Radiology, University of Cincinnati Medical Center, 3151 Bellevue Ave, Cincinnati, OH 45219
| | - Brian Guarnieri
- From the Division of Breast Radiology, Department of Diagnostic Radiology, University of Cincinnati Medical Center, 3151 Bellevue Ave, Cincinnati, OH 45219
| | - Kyle Lewis
- From the Division of Breast Radiology, Department of Diagnostic Radiology, University of Cincinnati Medical Center, 3151 Bellevue Ave, Cincinnati, OH 45219
| | - Mary C Mahoney
- From the Division of Breast Radiology, Department of Diagnostic Radiology, University of Cincinnati Medical Center, 3151 Bellevue Ave, Cincinnati, OH 45219
| | - Charmi Vijapura
- From the Division of Breast Radiology, Department of Diagnostic Radiology, University of Cincinnati Medical Center, 3151 Bellevue Ave, Cincinnati, OH 45219
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Brown AL, Vijapura C, Patel M, De La Cruz A, Wahab R. Breast Cancer in Dense Breasts: Detection Challenges and Supplemental Screening Opportunities. Radiographics 2023; 43:e230024. [PMID: 37792590 DOI: 10.1148/rg.230024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Dense breast tissue at mammography is associated with higher breast cancer incidence and mortality rates, which have prompted new considerations for breast cancer screening in women with dense breasts. The authors review the definition and classification of breast density, density assessment methods, breast cancer risk, current legislation, and future efforts and summarize trials and key studies that have affected the existing guidelines for supplemental screening. Cases of breast cancer in dense breasts are presented, highlighting a variety of modalities and specific imaging findings that can aid in cancer detection and staging. Understanding the current state of breast cancer screening in patients with dense breasts and its challenges is important to shape future considerations for care. Shifting the paradigm of breast cancer detection toward early diagnosis for women with dense breasts may be the answer to reducing the number of deaths from this common disease. ©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center. See the invited commentary by Yeh in this issue.
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Affiliation(s)
- Ann L Brown
- From the Department of Radiology, University of Cincinnati Medical Center, 3188 Bellevue Ave, Cincinnati, OH 45219-0772 (A.L.B., C.V., A.D.L.C., R.W.); and Department of Radiology, Ohio State University Medical Center, Columbus, Ohio (M.P.)
| | - Charmi Vijapura
- From the Department of Radiology, University of Cincinnati Medical Center, 3188 Bellevue Ave, Cincinnati, OH 45219-0772 (A.L.B., C.V., A.D.L.C., R.W.); and Department of Radiology, Ohio State University Medical Center, Columbus, Ohio (M.P.)
| | - Mitva Patel
- From the Department of Radiology, University of Cincinnati Medical Center, 3188 Bellevue Ave, Cincinnati, OH 45219-0772 (A.L.B., C.V., A.D.L.C., R.W.); and Department of Radiology, Ohio State University Medical Center, Columbus, Ohio (M.P.)
| | - Alexis De La Cruz
- From the Department of Radiology, University of Cincinnati Medical Center, 3188 Bellevue Ave, Cincinnati, OH 45219-0772 (A.L.B., C.V., A.D.L.C., R.W.); and Department of Radiology, Ohio State University Medical Center, Columbus, Ohio (M.P.)
| | - Rifat Wahab
- From the Department of Radiology, University of Cincinnati Medical Center, 3188 Bellevue Ave, Cincinnati, OH 45219-0772 (A.L.B., C.V., A.D.L.C., R.W.); and Department of Radiology, Ohio State University Medical Center, Columbus, Ohio (M.P.)
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Albasha H, Vijapura C, Brown A, Lewis K, Mahoney M, Wahab R. Beyond Breast Cancer: Chest Wall Masses at Breast Imaging. Radiographics 2023; 43:e220091. [PMID: 37079457 DOI: 10.1148/rg.220091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Affiliation(s)
- Heba Albasha
- From the Department of Radiology, University of Cincinnati, 3188 Bellevue Ave, Cincinnati, OH 45219
| | - Charmi Vijapura
- From the Department of Radiology, University of Cincinnati, 3188 Bellevue Ave, Cincinnati, OH 45219
| | - Ann Brown
- From the Department of Radiology, University of Cincinnati, 3188 Bellevue Ave, Cincinnati, OH 45219
| | - Kyle Lewis
- From the Department of Radiology, University of Cincinnati, 3188 Bellevue Ave, Cincinnati, OH 45219
| | - Mary Mahoney
- From the Department of Radiology, University of Cincinnati, 3188 Bellevue Ave, Cincinnati, OH 45219
| | - Rifat Wahab
- From the Department of Radiology, University of Cincinnati, 3188 Bellevue Ave, Cincinnati, OH 45219
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Spalluto LB, Bonnet K, Sonubi C, Ernst LL, Wahab R, Reid SA, Agrawal P, Gregory K, Davis KM, Lewis JA, Berardi E, Hartsfield C, Selove R, Sanderson M, Schlundt D, Audet CM. Barriers to Implementation of Breast Cancer Risk Assessment: The Health Care Team Perspective. J Am Coll Radiol 2023; 20:342-351. [PMID: 36922108 PMCID: PMC10042588 DOI: 10.1016/j.jacr.2022.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/19/2022] [Accepted: 12/24/2022] [Indexed: 03/16/2023]
Abstract
PURPOSE To assess health care professionals' perceptions of barriers to the utilization of breast cancer risk assessment tools in the public health setting through a series of one-on-one interviews with health care team members. METHODS We conducted a cross-sectional qualitative study consisting of one-on-one semistructured telephone interviews with health care team members in the public health setting in the state of Tennessee between May 2020 and October 2020. An iterative inductive-deductive approach was used for qualitative analysis of interview data, resulting in the development of a conceptual framework to depict influences of provider behavior in the utilization of breast cancer risk assessment. RESULTS A total of 24 interviews were completed, and a framework of influences of provider behavior in the utilization of breast cancer risk assessment was developed. Participants identified barriers to the utilization of breast cancer risk assessment (knowledge and understanding of risk assessment tools, workflow challenges, and availability of personnel); patient-level barriers as perceived by health care team members (psychological, economic, educational, and environmental); and strategies to increase the utilization of breast cancer risk assessment at the provider level (leadership buy-in, training, supportive policies, and incentives) and patient level (improved communication and better understanding of patients' perceived cancer risk and severity of cancer). CONCLUSIONS Understanding barriers to implementation of breast cancer risk assessment and strategies to overcome these barriers as perceived by health care team members offers an opportunity to improve implementation of risk assessment and to identify a racially, geographically, and socioeconomically diverse population of young women at high risk for breast cancer.
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Affiliation(s)
- Lucy B Spalluto
- Vice Chair of Health Equity, Associate Director of Diversity and Inclusion, Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; and Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; RSNA Cochair, Health Equity Committee.
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Chiamaka Sonubi
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Laura L Ernst
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Rifat Wahab
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio. https://twitter.com/RifatWahab
| | - Sonya A Reid
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, and Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Pooja Agrawal
- University of Texas Medical Branch, John Sealy School of Medicine, Galveston, Texas
| | - Kris Gregory
- R. Ken Coit College of Pharmacy, University of Arizona, Tucson, Arizona
| | - Katie M Davis
- Section Chief, Breast Imaging, Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jennifer A Lewis
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; Co-director clinical lung screening program, Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; and Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee; Rescue Lung Rescue Life Society Board Member
| | - Elizabeth Berardi
- Program Director, Tennessee Breast and Cervical Screening Program, Tennessee Department of Health, Nashville, Tennessee
| | - Crissy Hartsfield
- Clinical Programs Administrator, Division of Family Health and Wellness, Tennessee Department of Health, Nashville, Tennessee
| | - Rebecca Selove
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, and Director, Center for Prevention Research, Tennessee State University, Nashville, Tennessee
| | - Maureen Sanderson
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, and Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Carolyn M Audet
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee; Associate Director of the Vanderbilt Center for Clinical Quality and Implementation Research and Associate Director of Research in Vanderbilt Institute for Global Health
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Spalluto LB, Bonnet K, Sonubi C, Reid SA, Lewis JA, Ernst LL, Davis KM, Wahab R, Agrawal P, D'Agostino C, Gregory K, Berardi E, Hartsfield C, Sanderson M, Selove R, Schlundt D, Audet CM. Black Women's Perspectives on Breast Cancer Risk Assessment. J Am Coll Radiol 2023; 20:314-323. [PMID: 36922105 PMCID: PMC10027374 DOI: 10.1016/j.jacr.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/22/2022] [Accepted: 01/27/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE The aim of this study was to gather the perspectives of Black women on breast cancer risk assessment through a series of one-on-one interviews. METHODS The authors conducted a cross-sectional qualitative study consisting of one-on-one semistructured telephone interviews with Black women in Tennessee between September 2020 and November 2020. Guided by the Health Belief Model, qualitative analysis of interview data was performed in an iterative inductive and deductive approach and resulted in the development of a conceptual framework to depict influences on a woman's decision to engage with breast cancer risk assessment. RESULTS A total of 37 interviews were completed, and a framework of influences on a woman's decision to engage in breast cancer risk assessment was developed. Study participants identified several emerging themes regarding women's perspectives on breast cancer risk assessment and potential influences on women's decisions to engage with risk assessment. Much of women's decision context was based on risk appraisal (perceived severity of cancer and susceptibility of cancer), emotions (fear and trust), and perceived risks and benefits of having risk assessment. The decision was further influenced by modifiers such as communication, the risk assessment protocol, access to health care, knowledge, and health status. Perceived challenges to follow-up if identified as high risk also influenced women's decisions to pursue risk assessment. CONCLUSIONS Black women in this study identified several barriers to engagement with breast cancer risk assessment. Efforts to overcome these barriers and increase the use of breast cancer risk assessment can potentially serve as a catalyst to address existing breast cancer disparities. Continued work is needed to develop patient-centric strategies to overcome identified barriers.
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Affiliation(s)
- Lucy B Spalluto
- Vice Chair of Health Equity, Associate Director of Diversity and Inclusion, Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; and Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; RSNA Cochair, Health Equity Committee.
| | - Kemberlee Bonnet
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Chiamaka Sonubi
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Sonya A Reid
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, and Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jennifer A Lewis
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee; Co-director clinical lung screening program, Veterans Health Administration-Tennessee Valley Health Care System Geriatric Research, Education and Clinical Center (GRECC), Nashville, Tennessee; and Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, Tennessee; Rescue Lung Rescue Life Society Board Member
| | - Laura L Ernst
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Katie M Davis
- Section Chief, Breast Imaging, Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Rifat Wahab
- Department of Radiology, University of Cincinnati, Cincinnati, Ohio. https://twitter.com/%20RifatWahab
| | - Pooja Agrawal
- University of Texas Medical Branch, John Sealy School of Medicine, Galveston, Texas
| | - Chloe D'Agostino
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Kris Gregory
- R. Ken Coit College of Pharmacy, University of Arizona, Tucson, Arizona
| | - Elizabeth Berardi
- Program Director, Tennessee Breast and Cervical Screening Program, Tennessee Department of Health, Nashville, Tennessee
| | - Crissy Hartsfield
- Clinical Programs Administrator, Division of Family Health and Wellness, Tennessee Department of Health, Nashville, Tennessee
| | - Maureen Sanderson
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, and Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee
| | - Rebecca Selove
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, and Director, Center for Prevention Research, Tennessee State University, Nashville, Tennessee
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Carolyn M Audet
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee; Associate Director of the Vanderbilt Center for Clinical Quality and Implementation Research and Associate Director of Research in Vanderbilt Institute for Global Health
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7
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Vijapura C, Rosen L, Wahab R. Adenoid Cystic Carcinoma of the Breast: Radiologic-Pathologic Correlation. J Breast Imaging 2022; 4:625-631. [PMID: 38416992 DOI: 10.1093/jbi/wbac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Indexed: 03/01/2024]
Abstract
Adenoid cystic carcinoma (ACC) is an uncommon malignancy occurring most frequently in the salivary glands. Breast ACC is rare. Pain is common at the site of ACC; otherwise, presentation is similar to other primary breast cancers. Adenoid cystic carcinomas classically lack calcifications; the imaging manifestations of ACC are otherwise highly variable, likely related to multiple pathologic growth patterns. While ACC in other regions of the body tends to be more aggressive, ACC involving the breast typically has less aggressive biologic characteristics. Classic-type breast ACC has a lower tendency to recur locally with radiation, metastasize to regional lymph nodes, and spread to other parts of the body. Perineural spread of disease can be seen but is not common. The rarer solid basaloid-type has a higher tendency for local or distant spread and recurrence. Although ACC is usually triple receptor-negative (estrogen receptor, progesterone receptor, human epidermal growth factor-2 receptor), the indolent nature of this tumor dictates its management. With classic-type ACC, the inclusion of axillary surgery has no consensus and the use of chemotherapy or hormonal therapy is rare. Axillary nodal surgery and chemotherapy are often included in management of the more aggressive solid basaloid-type. An understanding of the breast imaging, histopathology, and clinical course is key for appropriate treatment and follow-up of ACC.
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Affiliation(s)
- Charmi Vijapura
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
| | - Lauren Rosen
- University of Cincinnati Medical Center, Department of Pathology, Cincinnati, OH, USA
| | - Rifat Wahab
- University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH, USA
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8
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Shaughnessy E, Vijapura C, Reyna C, Lewis J, Lewis K, Lee S, Sobel L, Wahab R, Rosen L, Brown A. Exploiting the advantages of a wireless seed localization system that differentiates between the seeds: Breast cancer resection following neoadjuvant chemotherapy. Cancer Rep (Hoboken) 2022; 6:e1690. [PMID: 35940632 PMCID: PMC9875611 DOI: 10.1002/cnr2.1690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/03/2022] [Accepted: 07/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Most wireless localization methods utilize only one means of detection for the surgeon, sufficient to localize a single small breast lesion for excision. Complex cases requiring bracketing of a larger lesion or localization of two or more close lesions can superimpose the signal from separate "seeds" with such methods. The lack of discernment between the localization "seeds" can disorient the surgeon, risking a missed lesion on excision and longer operative times. with the use of neoadjuvant chemotherapy prior to breast surgery, the necessity of localizing both a breast lesion and an axillary lymph node previously biopsied is becoming frequent. CASE A 44 year-old woman underwent neoadjuvant chmotherapy for a breast cancer the did not express estrogen receptor, progesterone receptor, or HER2 receptor. In establishing the extent of disease, a suspicious ipsilateral lymph node was biopsied and found to contain metastatic disease. She had an excellent response to the chemotherapy, with decreased size of the primary tumor and the previously biopsied lymph node. The patient desired breast conservation. The primary tumor and associated calcifications were bracketed using two different Smartclips™, with a third localizing the lymph node biopsied. CONCLUSION This report illustrates how the use of three SmartClips™, within the EnVisioTM system, allowed for separate tracking of each "seed" throughout a complex surgery in a patient following neoadjuvant chemotherapy. This resulted in successful resection of both the tumor and the tagged lymph node.
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Affiliation(s)
- Elizabeth Shaughnessy
- Department of Surgery, Section of Breast Surgery within Division of Surgical OncologyUniversity of CincinnatiCincinnatiOhioUSA
| | - Charmi Vijapura
- Department of Radiology, Division of Breast ImagingUniversity of CincinnatiCincinnatiOhioUSA
| | - Chantal Reyna
- Department of SurgeryCrozer Health SystemSpringfieldPennsylvaniaUSA
| | - Jaime Lewis
- Department of Surgery, Section of Breast Surgery within Division of Surgical OncologyUniversity of CincinnatiCincinnatiOhioUSA
| | - Kyle Lewis
- Department of Radiology, Division of Breast ImagingUniversity of CincinnatiCincinnatiOhioUSA
| | - Su‐Ju Lee
- Department of Radiology, Division of Breast ImagingUniversity of CincinnatiCincinnatiOhioUSA
| | - Lawrence Sobel
- Department of Radiology, Division of Breast ImagingUniversity of CincinnatiCincinnatiOhioUSA
| | - Rifat Wahab
- Department of Radiology, Division of Breast ImagingUniversity of CincinnatiCincinnatiOhioUSA
| | - Lauren Rosen
- Department of Pathology, Section of Surgical Pathology within Division of Anatomic PathologyUniversity of CincinnatiCincinnatiOhioUSA
| | - Ann Brown
- Department of Radiology, Division of Breast ImagingUniversity of CincinnatiCincinnatiOhioUSA
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9
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Swy E, Wahab R, Mahoney M, Vijapura C. Multimodality imaging review of breast vascular lesions. Clin Radiol 2021; 77:255-263. [PMID: 34961615 DOI: 10.1016/j.crad.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/19/2021] [Indexed: 11/25/2022]
Abstract
Breast vasculature is visualised on all screening and diagnostic imaging of the breast. Various vascular breast lesions exist, spanning from chronic systemic processes, congenital malformations, post-traumatic sequela, benign masses, to malignant tumours. Accurate diagnosis of vascular lesions on breast imaging can be difficult due to overlapping characteristics. Radiologists should be aware of key multi-technique imaging features to make an accurate diagnosis and to avoid unnecessary biopsies. This article reviews the normal vascular anatomy of the breast, commonly used imaging techniques to diagnose vascular lesions, and an in-depth review of various vascular breast lesions. Finally, management recommendations and clinical guidance are discussed so that the radiologist can appropriately triage these patients.
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Affiliation(s)
- E Swy
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street ML 0772, Cincinnati, OH, 45219-0772, USA
| | - R Wahab
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street ML 0772, Cincinnati, OH, 45219-0772, USA
| | - M Mahoney
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street ML 0772, Cincinnati, OH, 45219-0772, USA
| | - C Vijapura
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street ML 0772, Cincinnati, OH, 45219-0772, USA.
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Ali A, Wahab R, Huynh J, Wake N, Mahoney M. Imaging properties of 3D printed breast phantoms for lesion localization and Core needle biopsy training. 3D Print Med 2020; 6:4. [PMID: 32072305 PMCID: PMC7027021 DOI: 10.1186/s41205-020-00058-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/07/2020] [Indexed: 12/24/2022] Open
Abstract
Background Breast cancer is the most commonly diagnosed malignancy in females and frequently requires core needle biopsy (CNB) to guide management. Adequate training resources for CNB suffer tremendous limitations in reusability, accurate simulation of breast tissue, and cost. The relatively recent advent of 3D printing offers an alternative for the development of breast phantoms for training purposes. However, the feasibility of this technology for the purpose of ultrasound (US) guided breast intervention has not been thoroughly studied. Methods We designed three breast phantom models that were printed in multiple resins available through Stratasys, including VeroClear, TangoPlus and Tissue Matrix. We also constructed several traditional breast phantoms using chicken breast and Knox gelatin for comparison. These phantoms were compared side-by-side for ultrasound penetrance, simulation of breast tissue integrity, anatomic accuracy, reusability, and cost. Results 3D printed breast phantoms were more anatomically accurate models than traditional breast phantoms. The chicken breast phantom provided acceptable US beam penetration and material hardness for simulation of human breast tissue integrity. Sonographic image quality of the chicken breast phantom was the most accurate overall. The gelatin-based phantom also had acceptable US beam penetration and image quality; however, this material was too soft and poorly simulated breast tissue integrity. 3D printed phantoms were not visible under US. Conclusions There is a large unmet need for a printable material that is truly compatible with multimodality imaging for breast and other soft tissue intervention. Further research is warranted to create a realistic, reusable and affordable material to 3D print phantoms for US-guided intervention training.
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Affiliation(s)
- Arafat Ali
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, Cincinnati, OH, 45267, USA.
| | - Rifat Wahab
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, Cincinnati, OH, 45267, USA
| | - Jimmy Huynh
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, Cincinnati, OH, 45267, USA
| | - Nicole Wake
- Department of Radiology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA.,Department of Radiology, NYU Langone Health, Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, New York, 10016, NY, USA
| | - Mary Mahoney
- Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, Cincinnati, OH, 45267, USA
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Wahab R, Caton E. Outcomes of Early Enteral Nutrition in Ventilated Septic Shock Patients Receiving Vasopressor Therapy. J Acad Nutr Diet 2019. [DOI: 10.1016/j.jand.2019.08.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Ahmad J, Siddiqui MA, Akhtar MJ, Alhadlaq HA, Alshamsan A, Khan ST, Wahab R, Al-Khedhairy AA, Al-Salim A, Musarrat J, Saquib Q, Fareed M, Ahamed M. Copper doping enhanced the oxidative stress-mediated cytotoxicity of TiO 2 nanoparticles in A549 cells. Hum Exp Toxicol 2017. [PMID: 28621211 DOI: 10.1177/0960327117714040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Physicochemical properties of titanium dioxide nanoparticles (TiO2 NPs) can be tuned by doping with metals or nonmetals. Copper (Cu) doping improved the photocatalytic behavior of TiO2 NPs that can be applied in various fields such as environmental remediation and nanomedicine. However, interaction of Cu-doped TiO2 NPs with human cells is scarce. This study was designed to explore the role of Cu doping in cytotoxic response of TiO2 NPs in human lung epithelial (A549) cells. Characterization data demonstrated the presence of both TiO2 and Cu in Cu-doped TiO2 NPs with high-quality lattice fringes without any distortion. The size of Cu-doped TiO2 NPs (24 nm) was lower than pure TiO2 NPs (30 nm). Biological results showed that both pure and Cu-doped TiO2 NPs induced cytotoxicity and oxidative stress in a dose-dependent manner. Low mitochondrial membrane potential and higher caspase-3 enzyme (apoptotic markers) activity were also observed in A549 cells exposed to pure and Cu-doped TiO2 NPs. We further observed that cytotoxicity caused by Cu-doped TiO2 NPs was higher than pure TiO2 NPs. Moreover, antioxidant N-acetyl cysteine effectively prevented the reactive oxygen species generation, glutathione depletion, and cell viability reduction caused by Cu-doped TiO2 NPs. This is the first report showing that Cu-doped TiO2 NPs induced cytotoxicity and oxidative stress in A549 cells. This study warranted further research to explore the role of Cu doping in toxicity mechanisms of TiO2 NPs.
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Affiliation(s)
- J Ahmad
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia.,2 Al-Jeraisy Chair for DNA Research, King Saud University, Riyadh, Saudi Arabia
| | - M A Siddiqui
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia.,2 Al-Jeraisy Chair for DNA Research, King Saud University, Riyadh, Saudi Arabia
| | - M J Akhtar
- 3 King Abdullah Institute for Nanotechnology, King Saud University, Riyadh, Saudi Arabia
| | - H A Alhadlaq
- 3 King Abdullah Institute for Nanotechnology, King Saud University, Riyadh, Saudi Arabia.,4 Department of Physics and Astronomy, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A Alshamsan
- 3 King Abdullah Institute for Nanotechnology, King Saud University, Riyadh, Saudi Arabia.,5 Department of Pharmaceutics, Nanomedicine Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - S T Khan
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia.,2 Al-Jeraisy Chair for DNA Research, King Saud University, Riyadh, Saudi Arabia
| | - R Wahab
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia.,2 Al-Jeraisy Chair for DNA Research, King Saud University, Riyadh, Saudi Arabia
| | - A A Al-Khedhairy
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A Al-Salim
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - J Musarrat
- 6 Department of Agricultural Microbiology, Faculty of Agricultural Sciences, Aligarh Muslim University, Aligarh, India
| | - Q Saquib
- 1 Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia.,2 Al-Jeraisy Chair for DNA Research, King Saud University, Riyadh, Saudi Arabia
| | - M Fareed
- 7 College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - M Ahamed
- 3 King Abdullah Institute for Nanotechnology, King Saud University, Riyadh, Saudi Arabia
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Ebrahimi F, Gopalan V, Wahab R, Smith R, Lam A. 148 MIR-126 expression and redugaltion in colorectal cancer biology and its impact on clinicopathological features. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30046-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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14
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Umar A, Chauhan MS, Chauhan S, Kumar R, Sharma P, Tomar KJ, Wahab R, Al-Hajry A, Singh D. Applications of ZnO Nanoflowers as Antimicrobial Agents for Escherichia coli and Enzyme-Free Glucose Sensor. J Biomed Nanotechnol 2013; 9:1794-802. [DOI: 10.1166/jbn.2013.1751] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Sulaiman O, Hashim R, Wahab R, Ismail ZA, Samsi HW, Mohamed A. Evaluation of shear strength of oil treated laminated bamboo. Bioresour Technol 2006; 97:2466-9. [PMID: 16524726 DOI: 10.1016/j.biortech.2005.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Revised: 10/13/2005] [Accepted: 10/23/2005] [Indexed: 05/07/2023]
Abstract
Studies were carried out on heat treatment of bamboo species Gigantochloa scortechinii Gamble using palm oil. The samples were laminated and glued. The adhesion results showed that the delamination of glue line increased as the temperature and duration of oil heat treatment increased. Maximum load and shear strength of the glue line reduced as the heat treatment become more severe. It was found that the palm oil used as the heating medium penetrated in some parts of the cell wall as well as in the cell lumen of the bamboo.
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Affiliation(s)
- O Sulaiman
- Division of Bio-Resource, Paper and Coatings Technology, School of Industrial Technology, Universiti Sains Malaysia (USM), Penang, Malaysia.
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